Nokea
A client has squamous cell cancer of the right lung that has metastasized to the brain. In addition to chemotherapy for lung cancer, the physician prescribes lomustine (CeeNU), 100 mg/m2 as a single dose, to treat the brain metastasis. What are the major administration and excretion routes of lomustine?
- A. Oral administration and urinary
- B. I.V. administration and urinary excretion
- C. I.V administration and fecal excretion
- D. Oral administration and fecal excretion
Correct Answer: B
Rationale: Lomustine (CeeNU) is typically administered intravenously (I.V.), making choice B the correct administration route. Lomustine is metabolized in the liver and excreted primarily through the kidneys via urine, which accounts for its urinary excretion. Therefore, the major administration route for lomustine is intravenous (I.V.) and the major excretion route is urinary.
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gauge needle for drawing up medication and injecting it
- A. Inject the medication in the upper arm muscle
- B. Use a 1 inch needle to administer the medication
- C. Use the Z track technique to administer the medication
Correct Answer: B
Rationale: Using a 1 inch needle is the appropriate gauge needle for drawing up medication and injecting it. The length of the needle is important to ensure that the medication reaches the intended target area and is administered effectively. Shorter needles may not penetrate deep enough, while longer needles may increase the risk of complications such as injecting the medication into the wrong tissue or causing discomfort to the patient. Therefore, using a 1 inch needle is the correct choice for administering medication safely and accurately.
Which of the following malignancies is least likely to occur in a 10-month-old infant?
- A. neuroblastoma
- B. nephroblastoma
- C. retinoblastoma
- D. hepatoblastoma
Correct Answer: D
Rationale: Hepatoblastoma is rare in infants under 1 year old, being more common in toddlers.
A client with diabetes mellitus has a prescription for 5 U-100 regular insulin and 25 U of U-100 isophane insulin suspension (NPH) to be taken before breakfast. At about 4:30 p.m., the client experiences headache, sweating, tremor, pallor, and nervousness. What is the most probable cause of these signs and symptoms?
- A. Hyperglycemia
- B. Hyperuricemia
- C. Hypoglycemia
- D. Hypochondria
Correct Answer: C
Rationale: The signs and symptoms of headache, sweating, tremor, pallor, and nervousness described in the client suggest hypoglycemia, which is caused by low blood sugar levels. Insulin is a medication used to lower blood sugar levels in individuals with diabetes. In this case, the client has taken a combination of regular insulin and NPH insulin before breakfast, which could have led to a rapid drop in blood sugar levels by the afternoon causing the symptoms described. It is important to treat hypoglycemia promptly by giving the client a fast-acting carbohydrate source, such as glucose tablets or juice, to raise their blood sugar back to a safe level.
Autism screening is recommended for all children at age of
- A. 12 to 18 months
- B. 18 to 24 months
- C. 24 to 36 months
- D. 36 to 48 months
Correct Answer: B
Rationale: Autism screening is recommended between 18 and 24 months.
A 4-month old infant who has a congenital heart defect develops heart failure and is exhibiting marked dyspnea at rest . The nurse is aware this finding can be attributed to:
- A. Anemia
- B. Hypovolemia
- C. Pulmonary edema
- D. Metabolic acidosis blood specimen is obtained. The child's color becomes blue and respiratory rate increases to 44 bpm. Which of the following actions would the nurse do first?
Correct Answer: C
Rationale: The nurse would first assess for an irregular heart rate and rhythm. In a 4-month old infant with a congenital heart defect experiencing marked dyspnea at rest, the sudden onset of cyanosis (blue coloration) and increased respiratory rate can indicate worsening heart failure and potential arrhythmias. Assessing for any abnormal heart rhythms is a priority to determine if immediate intervention is required to stabilize the infant's condition and prevent further deterioration.